As with all couples attempting to achieve a pregnancy , you should focus on your own general health and lifestyle. It makes sense to be aiming for a healthy approach to life, but often advice in this area can be confusing and is not always supported by hard evidence. It is worth discussing any health concerns and medications you or your partner are taking with your doctor. Some medications have an effect on the production of sperm for the man, and for the woman there may need to be a change of medication before or during pregnancy.
As there is strong evidence that female smokers have reduced fertility and a higher miscarriage rate, this is the time to stop. Smoking during pregnancy has adverse effects on the growing baby and can contribute to many childhood illnesses. It is important to avoid smoking on the day of egg collection, as smoking can lead to anaesthetic difficulties. Husbands/partners should also stop smoking as there is increasingly clear evidence about the harmful effects of passive smoking.
While it is not possible to set "safe" limits of alcohol consumption, higher intakes are known to be harmful to the developing baby. The National Health and Medical Research Council (NH&MRC) recommends no more than two drinks per day for women and four for men, with at least two alcohol-free days per week, and considers abstinence to be desirable during pregnancy. We lack specific information about alcohol and infertility, except that a heavy intake in men can affect sperm production. It is important to be moderate in the second half of the menstrual cycle if pregnancy is possible, and in the weeks following a positive pregnancy test, as this is when the baby is developing. But there is no need to feel tortured with guilt if an occasional drink is taken.
A normal well-balanced diet, with plenty of leafy green vegetables for folic acid, is encouraged. The NH&MRC recommends that women take folic acid supplements of 0.5mg daily for the month before pregnancy and until the pregnancy is over 12 weeks, in the hope of reducing the risk of neural tube defects (most commonly spina bifida) in their babies. Although the effectiveness of this is not totally proven, there is good evidence linking folic acid with a reduced incidence of such abnormalities in high risk women. Women who take anti-epileptic medication and those with a family history of neural tube defects should take 5mg of folic acid daily.
If you are significantly overweight or underweight this can adversely affect fertility, it is worth considering your diet and perhaps discussing this with your doctor with the aim of getting dietary assistance.
High caffeine intake has been linked with female infertility in some research studies, but the reason for this is not obvious. Therefore it is worth considering a moderate coffee intake if you are trying to get pregnant.
Regular moderate exercise is totally acceptable. There is some evidence that strenuous exercise performed more than four times a week during pregnancy can have adverse effects. Frequent strenuous exercise, such as some athletic training programs, can also affect the body's hormone balance and thus the woman's fertility.
Direct relationships between stress and fertility have not been established; certainly some people conceive at times of high stress in their lives, while others will respond with ovulation disorders or a decreased libido. It makes sense to reduce stress in your life while undergoing IVF and trying to achieve a pregnancy. There are times before or during treatment that you may feel quite emotional or stressed; remember our counsellors are always available and are experienced in helping individuals and couples deal with difficult emotions and situations.
Prior to commencing the IVF program your consultant will order several routine tests. Each woman will have her rubella (German Measles) immunity checked (even if vaccinated in the past as immunity can fall). If the level is too low, a vaccination will be performed before attempting pregnancy, and a wait of 6 weeks is usually recommended before conceiving. Rubella can have devastating effects on the developing baby during pregnancy, and the disease is still prevalent in the community.
Both partners will be checked for Hepatitis B and C. A small particle of the hepatitis virus may remain in the blood and/or other body fluids for many years after the initial (often unsuspected) hepatitis infection. This may have significance for your future health, as well as for your partner, and for those who process your blood and semen samples.
If the woman has not had a Pap smear in the last couple of years, it is worth having one during this time and it should be repeated every two years - more often if abnormalities are found. Each month the woman should check her breasts for lumps or irregularities, and have her doctor check her breasts annually. It is worth considering that infertile women have a slightly increased incidence of cancer of some reproductive organs, and so these checks are important to your health.